National Provider Identifier [NPI]: |
1376555722 |
Last Name Of The Provider |
HUEBNER |
First Name Of The Provider |
TIMOTHY |
Middle Initial Of The Provider |
K |
Credentials Of The Provider |
MD |
Gender Of The Provider |
M |
Entity Type Of The Provider |
I |
Street Address 1 Of The Provider |
2031 PEACH ST |
Street Address 2 Of The Provider |
|
City Of The Provider |
WISCONSIN RAPIDS |
Zip Code Of The Provider |
544945181 |
State Code Of The Provider |
WI |
Country Code Of The Provider |
US |
Provider Type Of The Provider |
Family Practice |
Medicare Participation Indicator |
Y |
Number Of HCPCS |
129 |
Number Of Services |
3215 |
Number Of Medicare Beneficiaries |
226 |
Total Submitted Charge Amount |
304575 |
Total Medicare Allowed Amount |
79663.11 |
Total Medicare Payment Amount |
63923.52 |
Total Medicare Standardized Payment Amount |
66427.83 |
Drug Suppress Indicator |
|
Number Of HCPCS Associated With Drug Services |
11 |
Number Of Drug Services |
978 |
Number Of Medicare Beneficiaries With Drug Services |
86 |
Total Drug Submitted ChargeAmount |
6269 |
Total Drug Medicare AllowedAmount |
2855.26 |
Total Drug Medicare PaymentAmount |
2748.79 |
Total Drug Medicare Standardized Payment Amount |
2748.79 |
Medical SuppressIndicator |
|
Number Of HCPCS Associated With MedicalServices |
118 |
Number Of Medical Services |
2237 |
Number Of Medicare Beneficiaries With Medical Services |
226 |
Total Medical Submitted Charge Amount |
298306 |
Total Medical Medicare Allowed Amount |
76807.85 |
Total Medical Medicare Payment Amount |
61174.73 |
Total Medical Medicare Standardized Payment Amount |
63679.04 |
Average Age Of Beneficiaries |
73 |
Number Of Beneficiaries Age Less65 |
25 |
Number Of Beneficiaries Age 65 to 74 |
104 |
Number Of Beneficiaries Age 75 to 84 |
58 |
Number Of Beneficiaries Age Greater 84 |
39 |
Number Of Female Beneficiaries |
114 |
Number Of Male Beneficiaries |
112 |
Number Of Non Hispanic White Beneficiaries |
|
Number Of Black or African American Beneficiaries |
|
Number Of AsianPacific Islander Beneficiaries |
|
Number Of Hispanic Beneficiaries |
|
Number Of American Indian Alaska Native Beneficiaries |
|
Number Of Beneficiaries With Race Not Else where Classified |
|
Number Of Beneficiaries With Medicare Only Entitlement |
185 |
Number Of Beneficiaries With Medicare Medicaid Entitlement |
41 |
Percent Of With Atrial Fibrillation |
9 |
Percent Of With Alzheimers Disease or Dementia |
10 |
Percent Of With Asthma |
|
Percent Of With Cancer |
7 |
Percent Of With Heart Failure |
10 |
Percent Of With Chronic Kidney Disease |
14 |
Percent Of With Chronic Obstructive Pulmonary Disease |
7 |
Percent Of With Depression |
8 |
Percent Of With Diabetes |
25 |
Percent Of With Hyperlipidemia |
27 |
Percent Of With Hypertension |
47 |
Percent Of With Ischemic Heart Disease |
25 |
Percent Of With Osteoporosis |
6 |
Percent Of With Rheumatoid Arthritis Osteoarthritis |
25 |
Percent Of With Schizophrenia Other PsychoticDisorders |
5 |
Percent Of With Stroke |
|
Average HCC Risk Score Of Beneficiaries |
0.9207 |